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461~467.过继免疫治疗联合放化疗治疗非小细胞肺癌的Meta分析[J].郑雅文,李润美,魏枫,刘亮,张新伟,任秀宝.中国肿瘤生物治疗杂志,2013,20(4)
过继免疫治疗联合放化疗治疗非小细胞肺癌的Meta分析    点此下载全文
郑雅文  李润美  魏枫  刘亮  张新伟  任秀宝
天津医科大学 附属肿瘤医院 生物治疗科,天津市肿瘤免疫与生物治疗重点实验室,天津 300060;天津医科大学 附属肿瘤医院 生物治疗科,天津市肿瘤免疫与生物治疗重点实验室,天津 300060;天津医科大学 附属肿瘤医院 生物治疗科,天津市肿瘤免疫与生物治疗重点实验室,天津 300060;天津医科大学 附属肿瘤医院 生物治疗科,天津市肿瘤免疫与生物治疗重点实验室,天津 300060;天津医科大学 附属肿瘤医院 生物治疗科,天津市肿瘤免疫与生物治疗重点实验室,天津 300060;天津医科大学 附属肿瘤医院 生物治疗科,天津市肿瘤免疫与生物治疗重点实验室,天津 300060
基金项目:国家重点基础研究发展计划(973 计划)资助项目(No. 2012CB9333004);国家高技术研究发展计划(863计划)资助项目(No. SS2012AA020403);肿瘤医院临床试验专项基金资助项目(No. 11L01)
DOI:10.3872/j.issn.1007-385X.2013.04.014
摘要:
      目的: 探讨过继免疫治疗联合放化疗与单纯放化疗相比对非小细胞肺癌(non-small cell lung cancer,NSCLC)患者疗效的差异。 方法: 通过检索PubMed、Medline、EMBASE、Cochrane 数据库、中国期刊全文数据库和维普中文数据库,收集1995年1月至2012年9月发表的符合要求的随机化对照试验(randomized controlled trial,RCT)或非随机同期对照试验(non-randomized concurrent controlled trail,NRCCT),应用Revman5.0软件进行数据分析。 结果: 共纳入10项研究,共计1 326名患者。Meta分析结果显示:与单纯放化疗相比,过继免疫治疗联合放化疗能够提高患者2年无进展生存(progression-free survival,PFS)(OR=2.20,95%CI:1.44~3.36,P=0.0003)和2年总生存(OR=2.69,95%CI:1.92~3.78,P<0.00001)。接受过继免疫治疗后,早期和进展期NSCLC患者都能得到较大的获益\[(OR=3.24(1.65~6.35);OR=2.86(1.37~5.98)\]。过继免疫治疗引起的不良反应多呈自限性,主要有发热、寒战、恶心、乏力等,未观察到严重毒性反应。 结论: 过继免疫治疗联合放化疗能延缓NSCLC复发,提高患者生存期,且早期患者接受免疫治疗获益更显著。
关键词:过继免疫治疗  非小细胞肺癌  化疗  放疗  Meta分析  联合治疗
A Meta-analysis of adoptive immunotherapy combined with chemo/radio therapy in the treatment of non-small cell lung cancer    Download Fulltext
Zheng Yawen  Li Runmei  Wei Feng  Liu Liang  Zhang Xinwei  Ren Xiubao
Key Laboratory of Cancer Immunology and Biotherapy of Tianjin, Department of Biotherapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, China;Key Laboratory of Cancer Immunology and Biotherapy of Tianjin, Department of Biotherapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, China;Key Laboratory of Cancer Immunology and Biotherapy of Tianjin, Department of Biotherapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, China;Key Laboratory of Cancer Immunology and Biotherapy of Tianjin, Department of Biotherapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, China;Key Laboratory of Cancer Immunology and Biotherapy of Tianjin, Department of Biotherapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, China;Key Laboratory of Cancer Immunology and Biotherapy of Tianjin, Department of Biotherapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, China
Fund Project:Project supported by the National Key Basic Research Development Program (973 Program) of China (No. 2012CB9333004), the National High Technology Research and Development Program (863 Program) of China (No. SS2012AA020403), and the Special Foundation for Clinical Trials of Cancer Hospital (No. 11L01)
Abstract:
      Objective: To systematically assess the therapeutic effectiveness of adoptive immunotherapy combined with chemo/radio therapy compared with chemo/radio therapy alone in non-small cell lung cancer (NSCLC) patients. Methods: A systematic search of Pubmed, Medline, EMBASE, Cochrane Library, CNKI and VIP database from January 1995 to September 2012 was performed to identify the eligible randomized controlled trials (RCTs) and non-randomized concurrent controlled trails (NRCCTs). The improper documents were excluded. The soft-ware Revman5.0 was used for data synthesis. Results: A total of 10 studies involving 1 326 patients were identified. The result of Meta-analyses showed that adoptive immunotherapy combined with radio/chemo therapy improved the 2-year progression-free survival (PFS) (OR=2.20, 95%CI:1.44-3.36, P=0.0003) and 2-year overall survival (OR=2.69, 95%CI:1.92-3.78, P<000001). Both early-stage and advanced NSCLC patients benefited from adoptive immunotherapy (OR=3.24\[1.65-6.35\]; OR=2.86\[1.37-5.98\]). The adverse events were self limiting, including fever, chill, nausea, and fatigue. No severe toxicity was observed. Conclusion: Adoptive immunotherapy combined with chemo/radio therapy can decrease the risk of recurrence and improve the overall survival of NSCLC patients; early-stage patients receiving adoptive immunotherapy may benefit more.
Keywords:adoptive immunotherapy  non-small cell lung cancer  chemotherapy  radiotherapy  Meta-analysis  combination therapy
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